Handbook of Local Anesthesia. By MalarnedStanley F. Published by the C. V. Mosby Company. pp. 297; indexed; illustrated.

1064 accounts of the advantages or uses of pulse oximetry in almost every conceivable situation, including diving. There are one or two voices of dissent, such as Professor Andrew Thornton's conclusion that ear-lobe oximetry is not recommended for routine monitoring of dental patients undergoing general anaesthesia or sedation. However, pulse oximetry was not available to him at the time he performed his studies and he does say unequivocally that continuous monitoring of oxygen saturation has been a useful method for highlighting deficiencies of technique in dental anaesthesia. A feature of this book is the excellent discussion sections, which are interposed between groups of chapters. Here can be found the voice of sound common sense in Dr Ross Holland from New South Wales, who states that it is absolute garbage to assume that the only reason why things go wrong under anaesthesia and why people die, for example, is because of a mishap. He points out that, whereas this is true in 20% of patients (e.g. disconnection, misplaced tracheal tube, compromised airway), the other 80% who die in association with anaesthesia do so because somebody gave the wrong anaesthetic at the wrong time or they made an error of judgement and all the monitoring in the world would not have made any difference (e.g. inhalation of vomit). He emphasizes there is only one absolutely indispensable monitor and that is a trained, experienced person in the operating room. Let us hope that basic lessons from this work, such as those demonstrated by Drs Hanning and Abbott who detail the hypoxaemia that often occurs in the early stages of recovery from anaesthesia—that is during transportation from the operating theatre to the recovery room, and in the recovery room itself—will get home to anaesthetists. The major criticism of this work is that it appears to promote the sponsor's product the Biox oximeter. This is unfortunate as, given the title, the reader would have been greatly helped by an unbiased informed account of the merits and demerits (including differences in technology) of the other pulse oximeters which are available (e.g. Nellcor, Novametrix). Questions on the technology and performance of competitor's oximeters have largely gone unanswered. A. P. Adams

BRITISH JOURNAL OF ANAESTHESIA clinical experience and the use of other printed materials. The other use for the book will be for trainers—to assess their level of knowledge! J. Norman Handbook of Local Anesthesia.

By Stanley F. Malamed.

Published by the C. V. Mosby Company. Pp. 297; indexed; illustrated. This book is about local anaesthesia for dentistry. It is clearly the work of a great enthusiast who has gone to great lengths to produce a meticulously detailed and wide-ranging work that makes interesting reading whether you are a dentist or an anaesthetist. It starts by covering the neurophysiology of nerve conduction and the general principles of the pharmacology of local anaesthetic agents. The author discusses each of the commonly-used local anaesthetics in detail, and the vasoconstrictors. The next section on the armamentarium deals with equipment, syringes, needles, cartridges and so on, their use and care. The largest section of the book covers the techniques and is well illustrated with drawings and photographs. It starts by dealing with the medical assessment of patients and has a sensible discussion about common medical conditions and how these interact with dental treatment and local anaesthesia. My only major criticism of this book occurs in this area. The author states that amide-type local anaesthetics are absolutely contraindicated for malignant hyperpyrexia susceptible patients. He recommends ester-type local anaesthetics for such patients. This statement is erroneous and could lead to serious problems. There is no evidence that MHS patients are at risk from amide local anaesthetics and by recommending esters, which can cause serious allergy, these patients are being subjected to an unnecessary risk. This section goes on to discuss the general care of patients in the dental surgery and then covers the anatomy of the trigeminal nerve, the maxilla and the mandible. The two chapters on maxillary and mandibular anaesthesia cover many different blocks in great detail, with excellent illustrations. The final chapter in this section covers the application of local anaesthesia to the various dental specialties, including a useful section on paediatric 600 MCQs in Anaesthesia: Clinical Practice. By P. J. Simpson dentistry. and N. W. Goodman. Published by: Churchill LivingThe final section of the book deals with complications, both stone, Edinburgh. Pp. 232; not indexed or illustrated. local and systemic, and their management. The section on treatment of systemic toxicity is clear and lays the emphasis on Simpson and Goodman have previously produced a set of keeping the patient oxygenated, although no mention is made MCQ papers for the basic science of anaesthesia. This of tracheal intubation, despite the fact that, in the section on compilation of 10 papers with 60 questions in each follows the laryngeal oedema resulting from allergy, cricothyrotomy is same model, but is directed at clinical practice—in essence, at described. the Parts I and III of the F.F.A.R.C.S. The introduction offers the usual, necessary advice for all taking such examinations, in I found this an interesting and well produced book which terms of handling MCQ papers. The papers are a good mix covers its subject in sufficient detail to give its readers a and any candidate using them as a practice will get a reasonable thorough understanding of local anaesthesia for dentistry. I assessment of his or her likely mark. hope my own dentist has read it! The problem that candidates will have in using these sets will W. Macrae be in trying to make a distinction between the knowledge required for the Part I and that for the Part III examination. A Pockel-Book for Intensive Care. By J. Tinker and S. N. Each paper contains some questions on special anaesthesia Jones. Published by Edward Arnold (Publishers) Ltd, which will be more appropriate for the advanced trainee. London. Pp. 143; indexed; illustrated. Price £7.25. The main use of the book will thus be to enable candidates to assess their level of knowledge, especially if it is used as a This short work seeks to provide "useful practical information mock examination. One can also then learn from one's for medical and nursing staff working in intensive care units." mistakes. It would be a mistake to use the book as a prime The authors point out that it is not an addition to the range source of knowledge; that should come from good teaching, of works offering detailed instructions on clinical management.